多囊肾的血液动力学改变与肾功能变化的对比研究

目的探讨多囊肾患者的血液动力学改变与肾功能变化的相关性和敏感性。方法用彩色多普勒超声(CDFI)分别测定32例多囊肾患者(多囊肾组)和45例正常人(对照组)的肾主动脉(MRA)、肾段动脉(SRA)、肾叶间动脉(IRA)的收缩期峰值流速(Vman)、最小流速(Vmin)、搏动指数(PI)、阻力指数(RI),并检测血肌酐(Scr)、血尿素氮(BUN)水平,对其资料进行分析。结果肾功能正常的多囊肾组三级肾动脉的Vmax、Vmin均低于对照组(P<0.05),PI、RI明显高于对照组(P<0.05);肾功能代偿与失代偿的多囊肾组Vmax、Vmin显著低于对照组(P<0.01),PI、RI显著高于对照组(P<0.01)。Scr在肾功能代偿期即比对照组增高(P<0.05),失代偿期升高更显著(P<0.01);肾功能失代偿期BUN水平高于对照组(P<0.05)。结论(1)多囊肾患者的血液动力学改变早于肾功能的变化;(2)Vmax、Vmin的下降和PI、RI的增高与肾功能损害呈正相关。CDFI检测多囊肾的血流情况较常规肾功能测定敏感性好,为观察肾脏的血流与疾病的发展、治疗提供依据。

Paired Observation on the Change of Hemodynamics and Renal Function Variation in Polycystic Kidney Disease

Objective To explore the relativity and sensibility of the change of hemodynamics and renal function variation in patients with polycystic kidney.Methods Thirty-two patients with polycystic kidney and forty-five control subjects were enrolled.The maximal velocity(Vmax),minimum velocity(Vmin),pulse index(PI),resistance index(RI) of systole of the main renal artery(MRA),segment renal artery(SRA),interlobar renal artery(IRA) were measured.The serum creatinine(Scr),the blood urea nitrogen(BUN) were also measured and analyzed in the both groups.Results Compared with the control,the three levels renal artery in the patients with polycystic kidney whose renal functions were reduced.There was remarkable difference between the two groups(P<0.05).PI and RI were significant increased.Compared with the control,the Vmax,Vmin of the patients with polycystic kidney whose renal functions were abnormal that could be compensated or not were significantly reduced,there was significant difference(P<0.01).PI,RI significantly increased compared with the control(P<0.01).Scr increased slightly in renal functional compensatory period in contrast to that of the control group(P<0.05),while there was remarkable difference in renal functional decompensation period in contrast with that of control group(P<0.05),There was significant difference that BUN increased in decompensation period dcompared with the control group.Conclusions(1)The hemodynamics in the patients with polycystic kidney varies before the change of renal function.(2)The decrease of Vmax,Vmin and the increase of PI and RI has positive relarivity with the renal damage Color Doppler flow imaging(CDFI) can indicate the blood flow of polycystic kidney and it has higher sensitivity than the renal function,it will provde the basis of examination of the renal blood flow and growth and the therapy of the disease.